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CT Lung Screening’s Weak Link | RT Wages Jump
November 4, 2024
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Together with
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“There is no single solution to the puzzle of why lung cancer screening is so heartbreakingly underutilized. [E]fforts to motivate the public to pursue lung cancer screening must be met with equal efforts to provide pathways for them to connect, particularly among the medically disenfranchised.”
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DeSantis W et al, in a paper on ways to improve CT lung cancer screening rates.
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With all the great medical imaging software applications out there, it can be hard for radiology providers to keep up with the most current solutions. Enter subscription-based CT models, which enable imaging facilities to easily stay current with the state of the art. In this Imaging Wire Show, we talked to Saad Sirohey of GE HealthCare about how subscription-based CT works.
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CT lung cancer screening rates in the U.S. remain abysmally low, over a decade after the exam was recommended. Is part of lung screening’s problem its reliance on provider referrals? A new research letter in JAMA Network Open examines this question.
Unlike breast screening, in which eligible women are able to self-refer themselves for exams, CT lung screening revolves around provider referrals to start the process.
- CMS requires a shared decision-making session that results in a written order from a practitioner for a CT lung screening exam in order to pay for screening through Medicare and Medicaid.
When CMS created the rules in 2015, provider referrals and shared decision-making were seen as ways to get patients involved in their own care by making choices in coordination with their caregivers.
- But many are starting to see the requirements as a barrier, especially given low CT lung screening rates in the U.S.
In the new article, researchers investigated how easy it would be for an eligible individual to secure a CT lung screening appointment by just calling hospitals – without a provider referral.
- They note that one-third of Americans don’t have primary care clinicians, and are often told to call hospitals directly to set up appointments.
So they did just that, placing phone calls to 527 hospitals asking to arrange CT lung screening appointments, finding …
- 317 calls (60%) failed because the caller did not have a primary care provider’s order.
- Only 51 hospitals (9.7%) were able to connect callers to any component of a lung cancer screening process.
The study authors note that the provider referral requirement isn’t the only thing holding CT lung cancer screening back, as even patients with primary care providers aren’t getting screened, and managing nodule follow-up can also be challenging.
- But Medicare’s cumbersome reimbursement rules certainly don’t help bring new people into the fold.
The Takeaway
Given CT lung cancer screening’s undisputed life-saving value, there’s no reason to put unnecessary barriers in its way. The provider referral and shared decision-making requirements are lung screening’s weak link to securing greater adoption, and CMS should rescind them to put CT lung cancer screening on the path to greater adoption.
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Discover Prenuvo at RSNA 2024
Discover how Prenuvo is advancing research and redefining the future of healthcare at booth #1239 at RSNA 2024. Learn about their cutting-edge MRI technology first-hand and explore partnership opportunities.
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Meet Merge at RSNA 2024
Merge is looking forward to sharing a wide range of news, innovations, and updates at RSNA 2024. Join them at booth #6100 to explore how their imaging solutions put your workspaces, clinicians, and transformation into focus.
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Request an RSNA Meeting with TeraRecon
RSNA 2024 will be here before you know it. Come explore TeraRecon’s latest updates and find out why the company is an award-winning solution provider for AI-empowered radiology, oncology, cardiology, neurology, and vascular surgery.
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- RT Wages See Double-Digit Jump: There’s an upside to the radiologic technologist shortage, at least if you’re an RT: Wages have jumped 12% since 2022 and RTs now have an overall average salary of $86.5k. That’s according to the latest ASRT wage and salary survey, which found that nuclear medicine technologists enjoyed an even bigger increase, at 20% to an average annual salary of $106.5k. RTs in California had the highest annual salary at $125.8k, double that of Nebraska, the lowest-wage state at $61.9k.
- CMS Moves Ahead on Medicare Cuts: CMS on Friday issued a final rule for its 2025 Medicare Physician Fee Schedule that keeps in place a 2.83% cut in the conversion factor for physician services. The cuts were widely criticized when they were announced in July, but CMS has resisted calls to reduce them. The fight against the cuts now moves to Congress, which in the past has reversed Medicare payment reductions through legislation.
- AI of Breast MRI Predicts Cancer: A homegrown AI algorithm that analyzed breast MRI scans originally interpreted as normal predicted whether women would present with cancer up to a year later. In Academic Radiology, researchers developed a CNN algorithm and applied it to 910 breast MRI screening patients – it found 115 cancers detected on future screening exams. Radiologists could use the algorithm to re-evaluate cases the AI classifies as high risk; just reviewing 10% could catch 30% of otherwise undetected cancers on the next screening exam.
- Radioisotope Shortage Resolution? The global shortage of medical radioisotopes may not last as long as once feared, as a Dutch nuclear reactor is scheduled to reopen ahead of schedule. Nuclear Research and Consultancy Group said it would be restarting its High Flux Reactor on November 4, earlier than planned, and that the MARIA reactor in Poland would also be starting on November 1. The two reactors combined should alleviate shortages of radiotracers like molybdenum-99m, which is the precursor to the widely used cardiac imaging radiotracer technetium-99m.
- Merge Signs Summit Radiology: Merge signed an agreement to provide its imaging IT solutions to Summit Radiology, a teleradiology practice in Indiana. Merge will provide its Merge PACS, Merge VNA, and cloud-based Merge Workflow Orchestrator to Summit. Merge is partnering on the installation with AbbaDox, which will be the main source for radiology report distribution through its Cloud Fax and Referring Physician Portal. Summit serves over 50 clients across the U.S.
- More on Breast Ultrasound Screening: Ultrasound has been proposed as a primary breast screening modality in resource-challenged areas. A new project will try this approach in Uganda, combining iSono Health’s ATUSA whole-breast ultrasound scanner (cleared in 2022) with the EpiView-D4 cytology device, which extracts tissue specimens with fine-needle aspiration, analyzes them with a smartphone, and sends the data to clinicians. Vanderbilt University researchers received a $4M NCI grant to test a kit that combines both technologies for breast screening in 500 women in Uganda.
- Sirona Lands 9 New Sites: Sirona Medical has landed nine new radiology practices to implement its Unify cloud-native radiology workflow platform. The company launched Unify last year as a single platform that unites image review, reporting, universal worklist, and AI-based impression generation. Sirona expects 20 new practices to go live on the full Unify platform during 2025.
- Onboard X-Ray AI Detects Pneumothorax: An AI algorithm running onboard digital X-ray systems did a good job detecting emergent pneumothorax cases in a new study in Academic Radiology. Researchers examined outcomes in 12.7k chest X-rays acquired on systems running GE HealthCare’s Critical Care Suite 1.0, which analyzes images as they are acquired and alerts clinicians to emergent conditions like pneumothorax. AI reduced reporting time by 46% compared to studies acquired without AI, with sensitivity of 0.89 and specificity of 0.96 for moderate to large pneumothorax.
- Opportunistic AI Gets Cleared: HeartLung Technologies received FDA 510(k) clearance for AutoChamber, an AI algorithm for opportunistic detection of heart disease from non-contrast chest CT scans. AutoChamber can be added to CAC scoring and CT lung cancer screening studies to detect heart disease in patients before symptoms appear. HeartLung notes that AutoChamber was granted breakthrough device designation from the FDA, and the company plans to also introduce AI-CAC and AI-CVD algorithms for preventive cardiology.
- Bone Density from Photon-Counting CT: Speaking of opportunistic CT, researchers in a study in AJR evaluated bone mineral density using spectral localizer data from photon-counting CT lumbar spine scans. In a small study with 51 participants, they calculated area BMD values and T-scores from the scans, finding a concordance of 0.90 with DEXA scans and no statistically significant difference in T-scores. Photon-counting CT correctly classified 90% of cases, showing that it could provide BMD measurements in areas where adherence to DEXA screening is low.
- Breast CT Research Grant: Researchers at the University of Arizona received a $3.3M NCI grant to continue development of CT-based breast screening technology. U of A researchers developed a prototype breast CT scanner that acquires images with women in the prone position without breast compression. The new grant will be used to develop image reconstruction techniques and recruit 600 volunteers for further testing, with breast CT images compared to digital breast tomosynthesis.
- AI Fixes Poor-Quality Stroke CTA: German researchers used ClariPi’s ClariACE deep learning-based reconstruction software to clean up stroke CT angiography exams with poor iodine contrast image quality. In 102 patients with cerebral vessel occlusion, AI-enhanced images had higher signal-to-noise (109 vs. 38) and contrast-to-noise ratios (105 vs. 32). Mean vessel contrast as measured in Hounsfield units also went up (481 vs. 229 HU). AI reconstruction could speed time to treatment for stroke patients with poor-quality CTA exams.
- Vara Raises $9M for Breast AI: AI developer Vara raised $8.9M in funding to open up new international markets outside of its home country of Germany. The company’s AI platform is already deployed within Germany’s national breast screening program and processes 40% of mammography exams, some 100k images a month. Vara in particular is targeting India, and in 2023 signed a partnership with imaging services provider NM Medical.
- Konica Minolta Partners with Quinsite: Konica Minolta Healthcare is partnering with data analytics developer Quinsite to bring that company’s cloud-based analytics tools to Konica Minolta’s Exa Platform enterprise image management system. Exa Platform users will be able to employ Quinsite tools to analyze their imaging services to make more informed operational decisions.
- Real-World BAC Screening: Using AI to assess mammograms for breast arterial calcifications and identify women with greater CVD risks has been widely covered in medical journals, and a KFF Health News story reveals that it’s now expanding in clinical settings. Some imaging centers are now asking women whether they would also like their mammograms checked for heart disease risks (often for an out-of-pocket fee), although experts cited in the story voiced concerns about follow-up and that the absence of BAC doesn’t mean a patient doesn’t have high heart risks.
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Networked Radiology Empowers Radiologists
Join AGFA HealthCare at 11 am ET on November 12 for a webinar on how networked radiology can bridge health systems and empower radiologists. Learn about the role of networked radiology and get acquainted with new strategies for enterprise imaging implementation.
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Connect with United Imaging at RSNA 2024
United Imaging will be celebrating the theme of Building Intelligent Connections at RSNA 2024. Come visit the company at booth #1929 to learn about their imaging solutions and how they connect to United’s mission of Equal Healthcare for All.
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Redefining the Value of AI
Check out the next Road to RSNA virtual session from Microsoft at 2 pm ET on November 6 to discover how you can unlock value from your report data to improve quality, close the loop on patient follow‑up, and monitor AI performance.
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- Improve Patient Engagement with Effective Communication: Studies show that proactive communication reduces patient anxiety and improves adherence to appointments and follow-ups. This guide from PocketHealth offers strategies to create positive patient experiences and strengthen engagement. Download your guide here.
- Come See Enlitic at RSNA 2024: Visit Enlitic at RSNA 2024 at booth #4365 to learn how the company is revolutionizing radiology with its data standardization solutions, including data migration technology through its acquisition of Laitek. Book a demo today.
- The Clinical Value of Soft-Tissue Chest X-Ray: Soft-tissue techniques can improve the visibility and accuracy of chest X-ray. Learn about two important soft-tissue methods – bone suppression and dual-energy subtraction – in this white paper from Riverain Technologies.
- A Step-by-Step Approach to Radiology AI Adoption: Widespread adoption of radiology AI has the potential to revolutionize patient care, but the path to success requires a systematic approach. Blackford offers a step-by-step guide for healthcare providers looking to get started.
- Start at the Source to Improve MRI: Looking for ways to improve MRI speed and image quality while addressing broader concerns in healthcare? The answer may lie in proven MRI physics in your existing scanner – learn how to unlock it with STAGE from SpinTech MRI.
- Register Today for a Visage 7 Priority Demo: Visage continues to lead imaging’s managed services SaaS move to the cloud. Visage 7 CloudPACS solution. Register today for a priority demo at RSNA 2024 at booth #4329.
- AI for Detecting Fractures on X-Rays: Missed fractures occur all too frequently and are a significant cause of patient morbidity. Learn how U.K. researchers in the FRACT-AI study are using Gleamer’s BoneView algorithm to discover how AI can help radiologists improve their diagnostic accuracy for fracture detection on X-rays.
- Image Sharing to Streamline Workflow: Join Intelerad for a webinar at 12 pm ET on November 12 to explore how InteleShare optimizes image sharing in your practice. Discover how image sharing can streamline workflows, reduce delays, and integrate seamlessly with your existing systems
- AI for Lung Cancer Diagnosis and Screening: Check out this comprehensive new eBook from Calantic by Bayer on the role of AI in lung cancer diagnosis and screening. It explores AI’s potential role in improving lung cancer screening strategies, identifying high-risk individuals, and enhancing diagnostic accuracy. Download it today.
- Get the 2024 Radiology Practice Development Report: Medality surveyed more than 3,300 radiologists and discovered the most critical training gaps and growth opportunities in radiology for its 2024 Radiology Practice Development Report. Download your complimentary report today.
- Unifying All Your Diagnostic Images: The Mach7 eUnity enterprise diagnostic viewer can unify all your images and solve your integration needs under one universal viewing platform. Find out how you can upgrade your enterprise visualization strategy today.
- An End-to-End Solution for Viewing AI Output: Check out CARPL.ai’s FDA-cleared Universal AI View, an end-to-end solution for viewing, editing, and annotating AI outputs. It can be deployed on-premises or in the cloud to give you seamless interoperability. Book a meeting today to learn more.
- Give Patients a Clear Path to Accessing Medical Data: Clearpath is a simple integration that empowers digital delivery of medical records and images. Request a demo today to find out how you can ditch the disc and give your patients and third parties instant access to digital data.
- Fully Automated AI Echo vs. 3D and Human Readers: While 3D echo is becoming more accurate, 2D still dominates clinical care. A new study evaluates agreement in measures of LV volume and function between human readers, echo AI from Us2.ai, and the 3D Heart Model.
- Leading Radiology Forward at RSNA 2024: DeepHealth is leading radiology forward through AI-powered informatics and smart technology. Book a meeting today at RSNA 2024 booth #1340 to learn how they can help you achieve increased staff productivity and a better experience for patients and staff.
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